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长期补充谷胱甘肽对老年2型糖尿病患者氧化损伤的保护作用及对糖化血红蛋白(HbA1c)影响的随机临床试验

Randomized Clinical Trial of How Long-Term Glutathione Supplementation Offers Protection from Oxidative Damage and Improves HbA1c in Elderly Type 2 Diabetic Patients.

作者信息

Kalamkar Saurabh, Acharya Jhankar, Kolappurath Madathil Arjun, Gajjar Vijay, Divate Uma, Karandikar-Iyer Sucheta, Goel Pranay, Ghaskadbi Saroj

机构信息

Department of Zoology, Savitribai Phule Pune University, Pune 411007, India.

Biology Division, Indian Institute of Science Education and Research, Pune 411008, India.

出版信息

Antioxidants (Basel). 2022 May 23;11(5):1026. doi: 10.3390/antiox11051026.

Abstract

Complications in type 2 diabetes (T2D) arise from hyperglycemia-induced oxidative stress. Here, we examined the effectiveness of supplementation with the endogenous antioxidant glutathione (GSH) during anti-diabetic treatment. A total of 104 non-diabetic and 250 diabetic individuals on anti-diabetic therapy, of either sex and aged between 30 and 78 years, were recruited. A total of 125 diabetic patients were additionally given 500 mg oral GSH supplementation daily for a period of six months. Fasting and PP glucose, insulin, HbA1c, GSH, oxidized glutathione (GSSG), and 8-hydroxy-2-deoxy guanosine (8-OHdG) were measured upon recruitment and after three and six months of supplementation. Statistical significance and effect size were assessed longitudinally across all arms. Blood GSH increased (Cohen’s d = 1.01) and 8-OHdG decreased (Cohen’s d = −1.07) significantly within three months (p < 0.001) in diabetic individuals. A post hoc sub-group analysis showed that HbA1c (Cohen’s d = −0.41; p < 0.05) and fasting insulin levels (Cohen’s d = 0.56; p < 0.05) changed significantly in diabetic individuals above 55 years. GSH supplementation caused a significant increase in blood GSH and helped maintain the baseline HbA1c overall. These results suggest GSH supplementation is of considerable benefit to patients above 55 years, not only supporting decreased glycated hemoglobin (HbA1c) and 8-OHdG but also increasing fasting insulin. The clinical implication of our study is that the oral administration of GSH potentially complements anti-diabetic therapy in achieving better glycemic targets, especially in the elderly population.

摘要

2型糖尿病(T2D)的并发症源于高血糖诱导的氧化应激。在此,我们研究了在抗糖尿病治疗期间补充内源性抗氧化剂谷胱甘肽(GSH)的有效性。共招募了104名非糖尿病个体和250名接受抗糖尿病治疗的糖尿病个体,年龄在30至78岁之间,性别不限。另外,125名糖尿病患者每天口服500毫克GSH,为期6个月。在招募时以及补充3个月和6个月后,测量空腹和餐后血糖、胰岛素、糖化血红蛋白(HbA1c)、GSH、氧化型谷胱甘肽(GSSG)和8-羟基-2-脱氧鸟苷(8-OHdG)。纵向评估所有组别的统计学显著性和效应大小。糖尿病个体在3个月内血液GSH显著增加(科恩d值 = 1.01),8-OHdG显著降低(科恩d值 = -1.07)(p < 0.001)。事后亚组分析显示,55岁以上的糖尿病个体糖化血红蛋白(科恩d值 = -0.41;p < 0.05)和空腹胰岛素水平(科恩d值 = 0.56;p < 0.05)有显著变化。补充GSH导致血液GSH显著增加,并有助于总体维持基线糖化血红蛋白水平。这些结果表明,补充GSH对55岁以上的患者有相当大的益处,不仅有助于降低糖化血红蛋白(HbA1c)和8-OHdG,还能提高空腹胰岛素水平。我们研究的临床意义在于,口服GSH可能在实现更好的血糖目标方面补充抗糖尿病治疗,特别是在老年人群中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6298/9137531/a7108ded8aa1/antioxidants-11-01026-g001.jpg

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